WALLACE MENTAL HEALTH & ADDICTION COUNSELING LLC
NPI 1730817149
Social Worker - Clinical in Bartow, FL

Q: What is Wallace Mental Health & Addiction Counseling LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since August 12, 2022

1810 SADDLEWOOD PL, BARTOW, FL 33830(863) 529-3725 Get Directions Write a Review

NPPES record last updated: August 12, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Wallace Mental Health & Addiction Counseling Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALLACE MENTAL HEALTH & ADDICTION COUNSELING LLC (NPI 1730817149) is a healthcare organization registered as a clinical in Bartow, Florida and active in the NPI registry since August 2022. The organization lists Reginal A. Wallace, Licensed Clinician Social Worker, as its authorized official.

NPPES Registry Identity

NPI1730817149

Entity TypeOrganization

Primary Taxonomy1041C0700X

Legal Business NameWALLACE MENTAL HEALTH & ADDICTION COUNSELING LLC

Location Address1810 SADDLEWOOD PLBartow, FL 33830-2917

Mailing Address1810 Saddlewood PlBartow, FL 33830-2917 · (863) 529-3725

Phone(863) 529-3725

Organization SubpartNo

Authorized OfficialReginal A. WallaceLicensed Clinician Social Worker · (863) 529-3725

Enumeration DateAugust 12, 2022

NPPES CertifiedAugust 12, 2022

✔ NPI 1730817149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

1810 SADDLEWOOD PL, Bartow, FL 33830

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wallace Mental Health & Addiction Counseling Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Wallace Mental Health & Addiction Counseling LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Reginal Wallace, LCSW

Clinical Social Worker

NPI 1205400066

1201 1ST ST S
Winter Haven, FL 33880

(863) 293-1121

✔ PECOS11 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wallace Mental Health & Addiction Counseling LLC's NPI number?

The NPI number for Wallace Mental Health & Addiction Counseling LLC is 1730817149. It was assigned to this organization in the NPPES registry on August 12, 2022.

Where is Wallace Mental Health & Addiction Counseling LLC located?

Wallace Mental Health & Addiction Counseling LLC is located at 1810 Saddlewood Pl, Bartow, FL 33830. The listed phone number is (863) 529-3725.

What is Wallace Mental Health & Addiction Counseling LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Wallace Mental Health & Addiction Counseling LLC enrolled in Medicare?

Yes. Wallace Mental Health & Addiction Counseling LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wallace Mental Health & Addiction Counseling LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Wallace Mental Health & Addiction Counseling LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Wallace Mental Health & Addiction Counseling LLC was last updated on August 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.